The British journal of general practice : the journal of the Royal College of General Practitioners
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The integration of health and social care services is a potential solution for improving care, despite monetary constraints and increasing demand. How two or more multiple long-term conditions (MLTC) cluster, interact and associate with socioeconomic factors, and affect access to unscheduled primary healthcare services is understudied. ⋯ This study identified MLTC clusters by social care need with the highest primary care demand. Targeting clinical practice to prevent MLTC progression for these groups may lessen future pressures on primary care demand.
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IMG's experience disproportionally worse outcomes in GP Specialty Training when compared to their peers.1 This disparity in outcomes is not explained by any single identifiable trainee factor such as the academic ability, or trainee motivation and is called Differential Attainment.2Woolfe et al (2016) found factors such as lack of autonomy about the geographical location of work, combined with poor work-life balance can leave trainees unsupported, isolated, and vulnerable to anxiety, depression and other mental health conditions 3 coupled with potential stigma of supplementary help, anxiety about the increased probability of exam failure, visa difficulties and costs, all impact on the trainees' chances of progressing through training. 3 AIM: An evaluation of The Social Prescribing Scheme Pilot for International Medical Graduate GP Trainees in Yorkshire and the Humber. ⋯ Human factors such as accommodation and financial worries can have a huge impact on trainees' wellbeing and progression and should not be underestimated.
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Omission of pelvic examination (PE) has been associated with diagnostic delay in women diagnosed with gynaecological cancer. However, PEs are often not carried out by GPs. ⋯ GPs' reasons for carrying out, or not carrying out, PEs in women with symptoms potentially indicating cancer are complex. The COM-B framework provides a way of understanding this complexity. Interventions to increase the use of PEs, and critics of its non-use, need to consider these multiple factors.
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Each woman's experience of the perimenopause and/or menopause is individual and unique. Research shows women from ethnic minorities often have different experiences from their White peers, and these are not being considered in conversations about the menopause. Women from ethnic minorities already face barriers to help-seeking in primary care, and clinicians have expressed challenges in cross cultural communication including the risk that women from ethnic minorities' perimenopause and/or menopause health needs are not being met. ⋯ There is a need for increased awareness and trustworthy information resources to help women from ethnic minorities prepare for the menopause, and clinicians to recognise their experiences and offer support. This could improve women's immediate quality of life and potentially reduce future disease risk.
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Weather and seasons, or stressful periods associated with their education could affect young people's mental health. Members of a young person's advisory group asked us to investigate whether there are particular periods in the year when adolescents have more mental health issues. ⋯ There were higher rates of antidepressant prescribing, depression, and anxiety at the start of the school year in adolescents. Support around mental health issues from GPs and schools should be focused during this period. Future studies should examine whether these results apply to younger children and develop interventions to lessen their impacts on adolescents.